Global Collaboration for:  Reproductive Justice

Bernadette N. Kumar,  MD, PhD

Norwegian Institute of Public Health

Chair Global Society MERH; EUPHA Migrant and Ethnic Minority Health, Co Chair Lancet Migration 

ROMOMATTER FINAL CONFERENCE 

16.06.2021

 

Dr. Sally Hargreaves, St. Georges London/ECDC

Dr.Santino Severoni WHO Geneva

Prof. David Ingleby 

Jill Morrison

 Conclusions and Lessons Learned

Barriers in engaging policy makers/stakeholders (in reducing migrant and ethnic minority health  inequalities):
where evidence matters where governance matters 

 

  • It is not our concern (evidence, description)
  • We don’t know what to do (evidence, links)
  • We don’t know how to do it (delivery, networks)
  • We don’t want to – (levers, incentives, regulations)
  • We really don’t want to - ideology, no pressure so public pressure
  • We cant afford to – (cost efficacy, cross sectoral, prevention,other things matter more)

 

 

LESSONS LEARNED 

 

  • The urgent challenge - conclusions into practice. 
  • Tackling BOTH socioeconomic inequities and those linked to migrant/ethnic minority background
  • Tackling BOTH  ‘upstream’ measures and ‘downstream’measures

 

Tackling Inequity within the Health system

  • Address up stream initiatives such as Governance, Leadership and Data/Research Issues
  • Continue to address (formal and informal) barriers to accessing services
  • Advocate for ensuring legal entitlements are in place (in particular for  those that fall outside the system- in an irregular situation)
  • Adopt and implement migrant/ ethnic minority health policies

WAY FORWARD ……

    •  Knowledge/Data and Research 

 

  • We know the what but the why and how remain  
  •  Inequalities will remain undetected and unexplained

 

    •  Governance and Policy  
      •  Strengthen the leadership of efforts to improve health protection for MEM groups in each country 

 

  • Exclusion of migrants and ethnic minorities and other disadvantaged groups from national responses countries hinder full health protection for all
  • Apply an intersectoral, ‘whole-of-government’ approach to protecting MEM’ health, including health impact analyses of policies outside the health sector.

 

  • Equity is the Best Practise 
    •  Equity in migrant, ethnic minorities and other excluded or hard-to-reach communities
    • National Responses MUST include user engagement for prevention, protection and rehabilitation
    • Public Health Messaging must continue to adapt and extend reach to those most at risk   

Outside health systems

    • Equity in all polices
    • Inter-sectoral Action required 
    •  Use available evidence to dispel MEM myths 
    • Work with media to ensure  public opinion is not based on misinformation

 

  • Mobility has positive effect on HIC economies and services

 


https://romomatter.org/final-meeting/Acknowledgements

 

Empowering Roma Girls' Mattering through Reproductive Justice

https://romomatter.org/2021/04/05/we-can-be-example-of-life-possibilities-foir-girls/

A North American teen girl reflects on the situation of Roma girls

   By Ava Barish

 The Romomatter adaptation team interviewed teen girls from the anti-racist North American teen group Her Flowers to talk about reproductive justice, learn about Roma communities in Europe, and find ways to support Roma girls. Here we interviewed Ava Barish, a high school senior. 

 As a teen, what makes you want to be a part of something?

 Now, more than ever, a sense of community makes me really want to participate in things. While things that align with my interests are of course appealing to me, different things can also be attractive when I understand what the value of doing them is.

 What tools or resources would you use to spread a message you care about? 

I see social media used as a tool to spread information and resources amongst people my age. However, in my experience, this is actually often ineffective, as people often just scroll past. I usually use direct outreach to individual people when trying to spread a message, or ask groups or clubs to spread the message, as their members will be more responsive when the information comes from a group they are a part of.

 What message would you like to give to decision-makers about making sure that Roma girls can dream of their futures?

I think the most important message that I would like to communicate is that all people suffer when any people are oppressed. It is important to help those facing such oppression, even if the impacts are isolated in a small community, for the greater good of the entire society.

 How would you like to help?

 While I think I could try to help through spreading information and educating people in my community about these problems, I think it would be really meaningful to get to connect with the girls you work with. Though I don’t know what form that would take, especially given challenges like the language barrier, we could maybe help to be an example of what life could look like without a fixation on marriage, showing what the possibilities can be for girls. I think that connections between young people can be really powerful, perhaps more so than with adults.

 Any other thoughts you’d like to share about Roma girls or reproductive justice?

 I found this conversation to be really fascinating. I think it brings to light the privileged way in which people in the U.S. consider issues like reproductive justice, focusing just on abortion rights rather than the larger scheme of reproductive justice. I would like to see us continue to examine the way in which we may be naive as we consider certain issues facing our own communities. Furthermore, I would love to get to continue this discussion, particularly as it pertains to the Roma community, to see what more we can do to help not just educate ourselves but begin to act.

 Post navigation

Hosted by the collaboration of Health Leaders Assosciation and the Department of Operational Medicine,School of Medicine , the University of Pécs

 

The International Romomatter Conference event which was held in a hybrid format mid summer this year was followed by two Post Conference events:  „The Coalition Planning” and „The Coalition Day” co-hosted by the Health Leaders Assosciation and the department of Operational Medicine with colleagues from the WHO Collaboration Center in the city of Pécs, Baranya County Hungary.

The Coalition Days at aimed at bringing together the existing Romomatter Consortia with a wider network of field affiliated experts, community representatives and authorities at the local,regional and international levels featureing amongst all,  the local Roma Community representatives and experts from the Baranya region in order to initiate new rounds of joint grant applications and collaboration starting late Sepetmber and early October 2021.

Non-Romomatter Transdisciplinary Academicians , NGO leaders , Funding experts , local and international Authorities from Bostwana,The Netherlands Amsterdam and Arnhem, Snohomish Seattle, Rural Ohio and Cleveland, Emmerich Germany joined participated in the Coalition Planning and Coalition day events.

The Days attracted attention to the primary importance of the linkages between” Decent Jobs and  Empowerment „ facilitated by Quality Education and development of skills especially enterprenerial skills amongst Roma groups as well as the marginlazed as subjects of the future projects.

The importance of addressing the families and the intergenerational linkages as a topic of empowerment were underlined using international examples. 

The topics of earlier research conducted in Hungary such as the importance of deepening insights regarding the ethnic specific and Roma specific origins of diseases and life -styles especially those induced by poverty and the level of education were presented by Prof.Dr.István Kiss the Director of the Public Health Institute of the School of Medicine. The mentioned was proposed as a subject of  comparative study by the Coaltion.

The subject of international transferrability between international ethnic groups as well the marginalized as a subject of comparative study featured presentations by Citizen Empowerment expert and researcher Mr.Thuso Mphela and Ms.Zsófia Pasztor Sustainability Expert,Founder of the Transgenerational and Transculutural park regarding the similarities between topics of marginalization and culture, early mothehood, empowerment,gender justice and health outcomes amonsgt othe aboriginal tribes communities such as Basawra in Botswana were presented .

Mr.András Nun , Executive Director of the Autonómia Foundation one of the largest Roma expert organizations in Hungary , which dedicated to the topic both locally and internationally discussed areas of Roma specific inclusion  and health expectancy during his keynote „International Best Practices Project in Roma Health, Empowerment and Integrations” building on the earlier discussed areas of collaboration .

The growing importance of the field of Citizen Science taking a bottom approach for empowering citizen through engaging citizens was presented by Prof.Dr.Attila Sik the Director of the Transdisciplinary Discoveries based at the Medical School. The citizen mentoring piolt program and the outcomes were presented . The project’s implications for the Coalition’s future rounds was seen important in terms empowering through reconizing citizen’s ideation and innovation capacities by the acadmemician in order to create inclusive and empowered local ecosystems in a co-creative manner serving  well-being and sustainability

Dr.Timothy Boersamle from the Center for International Business Research (CIBR) of the International School of Business , of the HAN University based in Arnhem the Netherlands proposed led a session on the features of the Inclusive Participatory Action Research method adopted by Romomatter especially in combination with Photo voice and the model can be used in different contexts by the coalition, namely within context of Marginalized Community Health in the Netherlands. Co-creation across levels of educations, Co-Evaluation sisde by side gaps in literacy will receive specific attention .

The final panel of the Coalition Day reflected once again the priority of „Access to Education as a primary determinant of empowerment, inclusion, integration, justice and social participation amongst the Roma community” . The concept of embracing "The Catalytic Transdisciplinary Research for Development Methodology" for Communities of Practice focusing on Inclusion-Integration-Empowerment were included . The Sustainability Goals ( SDGs2030 ) and the Quintuple Helix Governance being sub-themes

Grant opportunities were presented by Dr.Csilla Vincze Director or the Civil Communities’ Center. Representatives of the Mayor of Sellye Rural Baranya hosting the Roma communities and the participants of the Ohio College of Health Sciences led integration program in Ormánság ,rural Baranya expressed the wider participation of the Mayors in the Coalition.

The events were also hosts to Romomatter advisors and members. Led by Prof.Dr.Margaret Greenfields Professor of Community Engagement and Social Policy from the Bucks University proposing a priority attention by the Coalition to experiences and expertise in the UK and colloborations for joint grant applications.

The Coalition Day closed with the joint ratification and emphasis by Assistant Dean Dr.Anca Minescu , of the Limerick University , regarding the establishment of a transdisciplinary and trans-sectoral sub-platform under the FEAMHP the (First European Migration Health Platform) founded jointly by the Health Leaders Association, the Department of Operational Medicine of School of Medicine in Pécs, the Colleges of Health Sciences and People Services in Athens Ohio and Toledo with contributions from the Director of Global Cleveland, participants of the rural Ohio-Pécs colleagues from Case Western Reserve , IOM, University of Amsterdam amongst others .

FEAMHP has embraced the SDGs2030 as a directifor building trans-sectoral and trans-disciplinary partnership

 

 

The Legacy of Cultural Contexts in the Lives and Identities of Minority Older Persons in Europe 

Cultural factors and social identities as a source of support for older people

 

 
 
”On ju meil kõigil üks suur unistus: olla vanaduses nii ilus ja tugev nagu üks vana puu.”
“All of us have a dream when we will be old; to be beautiful and strong as an old tree.”
 
Elfriede Bosien
 

 

Thirty years ago, the Berlin Wall, a symbol between East and West, the socialist and capitalist world, was overthrown. Europe believed in the idea of unity. Today we see that psychological and ideological walls are not that easily broken. Old migrants and old people from minorities carry in themselves identities that we do not see but that we must be able to identify to be able to provide intercultural elderly care. Identities are a social construct. Identities are dynamic and ever-changing concepts that are changed also through ideologies present in societies. The historical changes in political systems have affected the social identities of older people, old migrants, and older adults from minority groups. Identity is part of a person’s self-conception and self-perception, and it is also the result of labeling mechanisms arising from encounters between contrasting individuals and groups. Some of these mechanisms refer to family systems, religious systems, communication, and political systems.

This year we would like to invite ENIEC members to discuss the concept of social identities as a legacy of political systems. We would like to approach how this legacy has a direct impact in the context of providing intercultural social and health care for minority older people and old migrants in Europe, with special attention to identities among the elderly from East European countries who come from Soviet times.

We’re privileged to be invited to have the ENIEC Annual Meeting in Tallinn by the City of Tallinn. We’re happy to announce that Tallinn City Government is supporting our meeting and inviting us to have our Opening Ceremony at Tallinn Raekoda, Tallinn City Hall. www.tallinn.ee/eng/

Siiri Jaakson, Chair of the Organizing Committee,
with Tuulikki Hakala, Eva Rönkkö, Susanna Lehtovaara, Inka Lehtonen and Alina Ahtamo

 

Registration information

Registration to Annual Meeting 2020 in Tallinn has ended on 10th February 2020. If you wish to require extra places, please send us email at This email address is being protected from spambots. You need JavaScript enabled to view it. 

Due to hotel regulations, we must confirm the number of participants in advance. All participants who register after this date are still welcome, but they must pay the penalty of the hotel (extra 100€).

The Program of the Annual Meeting is here.

Statement by the European Public Health Association (EUPHA) on migration, ethnicity and health

Migrants and ethnic minorities (MEM) often face serious inequities concerning both their state of health and their access to good quality health services. These inequities are increasingly being brought to light by public health researchers, but action to tackle them has lagged behind. To ensure that adequate attention is paid to the determinants of MEM health and the problems of service delivery that can confront these groups, health systems need to become more inclusive. The rising tide of populism and nationalism in European politics has created a hostile environment for such reforms.

Nevertheless, a new willingness to stand up for migrants’ rights is emerging at the level of international organisations. Member organisations such as the IOM, WHO, ILO and UNHCR have succeeded in placing migration centre stage at the United Nations, where ‘Global Compacts’ on migrants and refugees are currently being drafted.1 These are linked to the Sustainable Development Goals (SDGs) that define the UN’s development programme for 2015-2030.

The SDG’s, with their maxim of ‘leaving no-one behind’ and their emphasis on equity in all countries (not just ‘developing’ ones), provide welcome and explicit support for efforts to combat inequities in MEM health.

For those who are unwilling to see research on MEM health limited to a purely academic enterprise, these are encouraging moves. However, policies can only be as good as the data they are based on. EUPHA is therefore issuing this call to reduce the gap between researchers and policy-makers, in particular those responsible for setting research priorities and implementing findings. The statement addresses the following key issues, which are discussed in more detail in the Explanatory Memorandum:2 1.

The need for evidence-based policies on MEM health. How can the evidence base for policy reforms be strengthened? a. Fundamental concepts and data collection The need for more and better data should be the first priority in MEM health. Because of the failure of research funding bodies and health system managers to recognise the importance of a strong evidence base, researchers and service providers alike suffer from a shortage of crucial data.

Progress is also hampered by the lack of harmonisation of fundamental concepts.

1 https://refugeesmigrants.un.org/migration-compact

2 https://bit.ly/2KN66jV

b. MEMs’ state of health and its determinants Epidemiological evidence, based on population-based rather than clinical data, is badly lacking on many topics. On the principle “no smoke without fire”, it is often assumed that migrants’ main health problems are those on which most research has been carried out. However, priorities are often defined by myths rather than realities.

c. Issues concerning service delivery The interaction between health services and their MEM users, including issues of access, quality, utilization and communication, has become a major field of research within EUPHA.

Not enough attention is paid to the need to adapt health services to the needs of migrant and minority users. Quite independently of their particular vulnerabilities, MEMs have the right to affordable and effective health services of all kinds and at all times, not only in emergencies. Considerations of immigration policy should never be allowed to stand between them and the help they need.

2. The target group. Whereas most international organizations tend to confine their attention to migrants, the position of EUPHA has always been that ethnic minorities need to be considered as well. These include the descendants of migrants as well as indigenous minorities. Such groups may experience inequities at least as great as those affecting migrants, and often similar in nature. This has implications for data collection: both ethnicity and migrant status need to be taken into account.

3. The diversity of MEM groups. Over-generalising approaches that fail to acknowledge diversity within groups need to be replaced by ‘intersectional’ analyses that examine simultaneously the effects of socioeconomic position, sex/gender, age and many other variables, as well as their interactions. Instead of being targeted at monolithic categories such as ‘migrants’, ‘refugees’ or ‘minorities’, policies should focus on within-group differences and real need. A ‘grapeshot’ approach encourages stereotyping and inaccurate targeting. Neither migrants, refugees nor ethnic minorities should be labelled in their entirety as ‘vulnerable groups’: to do so is to stigmatise them and underestimate their strength and resilience. In service delivery, ‘diversity sensitivity’ is to be preferred to a narrow emphasis on ‘cultural competence’.

4. The need to return to a broader framing of migration. The influx of unauthorised entrants to the EU in 2015-2016 (the so-called ‘migrant crisis’) has led to a one-sided focus on the needs of forced and irregular migrants – ignoring the ‘routine’3 migration that is in no way a ‘crisis’. Moreover, whereas the response of policy-makers to the 2015-2016 influx focused mainly on asylum seekers and refugees, many of the newcomers have joined the EU’s existing population of migrants in irregular situations; this group is all too often neglected in both research and policy-making. 3 The word ‘routine’ is preferred to ‘regular’, in order to emphasize the fact that asylum seekers, despite often entering without authorisation, regularise themselves by making an asylum application. However, we do not wish to classify asylumseeking as ‘routine’. The distinction ‘forced/unforced’ is also avoided, because research has shown that it is impossible to regard these as mutually exclusive categories.

5. Combating the fragmentation of MEM health policy in Europe. Much duplication of effort and ‘reinventing the wheel’ results from insufficient coordination within and between responsible agencies. In addition to the intrinsic divisions between European countries and language communities, regional and international organisations often compete with each other instead of cooperating, which leads to wasted effort and lost opportunities to create synergies. Priorities should be based on the latest insights into public health and the position of MEM in today’s Europe.

6. More attention in EU research programmes for MEM health. MEM health was a central topic in the First and Second Programmes of the European Commission (EC), but apart from a sudden surge in financing for projects on asylum seekers and refugees, it has been seriously neglected so far in the Third Health Programme. EUPHA is concerned about the lack of attention in this programme for health inequities in general, and those affecting MEMs in particular.

7. Better provision of education and training on MEM health. Although this Statement is primarily concerned with the links between research and policy-making on MEM health, capacity building in both areas has to be supported by education and training directed at health workers of all kinds, researchers, managers and policy makers. This should not only be provided in optional additional courses, but as part of basic curricula.

For more information, please contact Prof Allan Krasnik, president of the EUPHA section on Migrant and ethnic minority health, This email address is being protected from spambots. You need JavaScript enabled to view it., or Dr Dineke Zeegers Paget, EUPHA executive director, This email address is being protected from spambots. You need JavaScript enabled to view it.. The European Public Health Association, or EUPHA in short, is an umbrella organisation for public health associations in Europe.

Our network of national associations of public health represents around 20’000 public health professionals. Our mission is to facilitate and activate a strong voice of the public health network by enhancing visibility of the evidence and by strengthening the capacity of public health professionals. EUPHA contributes to the preservation and improvement of public health in the European region through capacity and knowledge building. We are committed to creating a more inclusive Europe, narrowing all health inequalities among Europeans, by facilitating, activating, and disseminating strong evidence-based voices from the public health community and by strengthening the capacity of public health professionals to achieve evidence-based change.

EUPHA - European Public Health Association E-mail This email address is being protected from spambots. You need JavaScript enabled to view it. Internet www.eupha.org Twitter @EUPHActs

See also:http://www.merhcongress.com/wp-content/uploads/2018/05/EUPHA-statement-on-migrant-and-ethnic-minority-health1.pdf

 

Open meeting on a forming a Global Society at lunchtime on Saturday 19th May 2018

This proposal is for a new Global Society to integrate academic, professional and community work on the following interrelated fields: migration, ethnicity, race and Health. The meeting will offer an opportunity for participants to suggest other ways of achieving the same goal. Rationale The 1st World Congress is fostering an integrated dialogue on issues related to migration, ethnicity (and a focus on indigenous and Roma populations) and race, as they relate to health and health care. A major motivation for this Congress was that they are of central importance in public health and health care, especially in relation to equity and equality with the sense that these fields of study and practice, notwithstanding their differences, have much in common, warranting a global endeavour.

The core idea behind a Global society and this proposal is that greater unity, crossworking, and cross fertilisation of ideas through dialogue would strengthen each field separately and hence also collectively. The high participation and the richness of the contributions at this Congress, despite the sparse representation of some parts of the world (e.g. much of Africa, Russia, East and Southeast Asia and Latin America), provide the impetus for creating a Global Society to nurture and further the dialogue. The question to be considered in this meeting is whether such a Society would add value in the current context where there are numerous organisations working in the field, sometimes in formal collaborations, though these are seldom global or encompassing all the identified fields. There are also serious and important questions about the mode of organisation. To be practical, a new Society would likely need to be a coalition of organisations already working in the fields.

Then the main objective of the new organisation would be to enhance cooperation and dialogue across them. There will be important challenges in relation to funding, sustainability and choices between activities.

Next steps 1.

To discuss this proposal in open session to identify the important questions and gauge the degree of support for it.

2. If there is support, to reflect on the core objectives of the new Society and the mode of its organisation. The primary objective could be to promote a dialogue across the fields identified, hopefully allowing us to speak with a unified voice and influence global policies. One specific action might be to help catalyse future World Congresses of the kind we are currently participating in. Our current Congress was an initiative of the Migrant and Ethnic Health Section of the European Public Health Association and incorporates the seventh European meeting of this section.

This model may well work in the future i.e. identifying similar organisations in other parts of the world that run regional meetings and foster collaborations so their meetings can become , on occasion, global. In parts of the world where such organisations do not already exist our Society might promote their development. The next Congress might possibly be in 4-years’ time (2022), so it is a rare event and not clashing with other major meetings. There may be other objectives e.g. fostering networks, creating an internet presence, setting up a newsletter et cetera. As indicated above, the mode of organisation would likely be to develop a coalition of existing organisations and societies working in the field. To our knowledge, none of these straddle the range of fields represented in our current Congress, and certainly not on a global scale. While this needs to be negotiated, we would hope that the coalition partners of this new Society would help provide the relatively small-scale resources required to initiate the work of the Society for short periods of time e.g. two years. 3. Again, given support, we will need a Committee to oversee the work above. The first task will be to identify and communicate with coalition partners. Small-scale funds will be needed. If there is a surplus from this 1st Congress then that might be used for the new group. If not, we may need some seed funding from another funder. A good starting point might be to approach the sponsors of this current Congress. 4. The composition of the Committee needs to be agreed but given the range of fields identified and the global work of the Society it is likely that 15-20 people will need to serve. It would probably be best if these people represented national, regional and international organisations that are already working in these fields to avoid unnecessary duplication of work and to help build alliances. The composition of the Committee is likely to follow standard approaches as follows: Chairperson Secretary Treasurer Members representing major organisations working in the identified fields e.g. APHA, EUPHA, RWJ Foundation etc. Members representing academic, professional and community (NGO etc.) interests In keeping with the rationale and fields of work the composition of the Committee should reflect the diversity of the populations to be served by the new Society.

In addition to the committee there may be advisory groups.

See : http://www.merhcongress.com/wp-content/uploads/2018/05/FINAL-International-Society-Proposal-26th-April-2018.pdf

 

TEAMHP members are planning an active participation at the upcoming MERH Congress.(read below, also http://www.merhcongress.com/)

TEAMHP's Executive Commitee has been encouraging members from across the continent to come this important gathering as it can be a unique follow-up opportunity after the MH-PIE Foundation event of TEAMHP in October 2017

MERH

The MERH 2018 Congress is hosted by an independent, non-profit making company working under the auspices of The University of Edinburgh, the European Public Health Association and NHS Health Scotland.  We intend to deliver you a memorable, affordable, academic and social programme in one of the most spectacular cities in the world.

The MERH congress will replace the 7th EUPHA Migrant and Ethnic Health Section Conference. 

Congress aims :

  • Improve research, population health and health care for migrants and other discriminated-against populations
  • Bring together policy, social science, clinical, social service and public health perspectives and share and transfer learning within and across countries
  • Examine contemporary problems across the globe and debate suggested solutions
  • Consider health effects of social, environmental and demographic change associated with population migration, and the effects on diseases and their causes
  • Find ways to overcome differences in concepts and terminology so the field can be understood internationally in acceptable language
  • Provide opportunities for people to showcase their work and to meet to share experience and motivations
  • Build networks that will last beyond the Congress itself

TEAMHP representatives have been actively involved in conversations and haave had the opportunity to present ongoing projects  with ENIEC members at the annual meeting this year held in Madrid and San Lorenzo de El Escorial,Spain

Eugenia Canaan, Erika Marek, Arnold Nikolett were TEAMHP members at the event

The event this year was also a host Jairo Nunez Criollo (Second Secretary General of the Ecuadorian Consulate in Mardid),Albin O.Larsson the Project Manager at Tehe Swedish Trade and Invest Council for Spain, Portugal and Portuguese speaking Africa

 

President of Global Cleveland , Mr.Joe Cimperman has proposed the idea of building Sister Cities relationship between Cleveland and Pécs during the Post Paprika event meeting  with Cleveland Hungarian Development Panel's Board members and TEAMHP's representatives at the Union Club.

Currently,Cleveland has a similar relationship with the city of Miskolc in Hungary. Now, given the newer opportunities and promises brought by TEAMHP especially in the area of Circular Innovation and Circular Migration, the sister city relationship can offer strategic possibilities to all of the direct and indirect stakeholders

Page 1 of 2